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1.
Nat Methods ; 21(5): 835-845, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38374265

RESUMO

Modern multiomic technologies can generate deep multiscale profiles. However, differences in data modalities, multicollinearity of the data, and large numbers of irrelevant features make analyses and integration of high-dimensional omic datasets challenging. Here we present Significant Latent Factor Interaction Discovery and Exploration (SLIDE), a first-in-class interpretable machine learning technique for identifying significant interacting latent factors underlying outcomes of interest from high-dimensional omic datasets. SLIDE makes no assumptions regarding data-generating mechanisms, comes with theoretical guarantees regarding identifiability of the latent factors/corresponding inference, and has rigorous false discovery rate control. Using SLIDE on single-cell and spatial omic datasets, we uncovered significant interacting latent factors underlying a range of molecular, cellular and organismal phenotypes. SLIDE outperforms/performs at least as well as a wide range of state-of-the-art approaches, including other latent factor approaches. More importantly, it provides biological inference beyond prediction that other methods do not afford. Thus, SLIDE is a versatile engine for biological discovery from modern multiomic datasets.


Assuntos
Aprendizado de Máquina , Humanos , Biologia Computacional/métodos , Animais , Análise de Célula Única/métodos , Algoritmos
2.
PLoS Biol ; 19(6): e3001233, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34061820

RESUMO

The glymphatic system plays an important role in clearing the amyloid-ß (Aß) and tau proteins that are closely linked to Alzheimer disease (AD) pathology. Glymphatic clearance, as well as Aß accumulation, is highly dependent on sleep, but the sleep-dependent driving forces behind cerebrospinal fluid (CSF) movements essential to the glymphatic flux remain largely unclear. Recent studies have reported that widespread, high-amplitude spontaneous brain activations in the drowsy state and during sleep, which are shown as large global signal peaks in resting-state functional magnetic resonance imaging (rsfMRI), are coupled with CSF movements, suggesting their potential link to glymphatic flux and metabolite clearance. By analyzing multimodal data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) project, here we showed that the coupling between the global fMRI signal and CSF influx is correlated with AD-related pathology, including various risk factors for AD, the severity of AD-related diseases, the cortical Aß level, and cognitive decline over a 2-year follow-up. These results provide critical initial evidence for involvement of sleep-dependent global brain activity, as well as the associated physiological modulations, in the clearance of AD-related brain waste.


Assuntos
Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/patologia , Encéfalo/patologia , Encéfalo/fisiopatologia , Reologia , Idoso , Doença de Alzheimer/sangue , Doença de Alzheimer/fisiopatologia , Peptídeos beta-Amiloides/metabolismo , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/sangue , Disfunção Cognitiva/líquido cefalorraquidiano , Disfunção Cognitiva/complicações , Disfunção Cognitiva/fisiopatologia , Feminino , Humanos , Masculino , Oxigênio/sangue , Fatores de Risco
3.
J Immunol ; 207(11): 2710-2719, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34740959

RESUMO

The single-nucleotide polymorphism (SNP) rs3184504 is broadly associated with increased risk for multiple autoimmune and cardiovascular diseases. Although the allele is uniquely enriched in European descent, the mechanism for the widespread selective sweep is not clear. In this study, we find the rs3184504*T allele had a strong association with reduced mortality in a human sepsis cohort. The rs3184504*T allele associates with a loss-of-function amino acid change (p.R262W) in the adaptor protein SH2B3, a likely causal variant. To better understand the role of SH2B3 in sepsis, we used mouse modeling and challenged SH2B3-deficient mice with a polymicrobial cecal-ligation puncture (CLP) procedure. We found SH2B3 deficiency improved survival and morbidity with less organ damage and earlier bacterial clearance compared with control mice. The peritoneal infiltrating cells exhibited augmented phagocytosis in Sh2b3 -/- mice with enriched recruitment of Ly6Chi inflammatory monocytes despite equivalent or reduced chemokine expression. Rapid cycling of monocytes and progenitors occurred uniquely in the Sh2b3 -/- mice following CLP, suggesting augmented myelopoiesis. To model the hypomorphic autoimmune risk allele, we created a novel knockin mouse harboring a similar point mutation in the murine pleckstrin homology domain of SH2B3. At baseline, phenotypic changes suggested a hypomorphic allele. In the CLP model, homozygous knockin mice displayed improved mortality and morbidity compared with wild-type or heterozygous mice. Collectively, these data suggest that hypomorphic SH2B3 improves the sepsis response and that balancing selection likely contributed to the relative frequency of the autoimmune risk variant.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/imunologia , Sepse/imunologia , Proteínas Adaptadoras de Transdução de Sinal/genética , Adulto , Animais , Modelos Animais de Doenças , Humanos , Camundongos , Camundongos Congênicos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Polimorfismo de Nucleotídeo Único/genética , Sepse/genética
4.
Mov Disord ; 36(9): 2066-2076, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33998068

RESUMO

BACKGROUND: Deposition and spreading of misfolded proteins (α-synuclein and tau) have been linked to Parkinson's disease cognitive dysfunction. The glymphatic system may play an important role in the clearance of these toxic proteins via cerebrospinal fluid (CSF) flow through perivascular and interstitial spaces. Recent studies discovered that sleep-dependent global brain activity is coupled to CSF flow, which may reflect glymphatic function. OBJECTIVE: The objective of this current study was to determine if the decoupling of brain activity-CSF flow is linked to Parkinson's disease cognitive dysfunction. METHODS: Functional and structural MRI data, clinical motor (Unified Parkinson's Disease Rating Scale), and cognitive (Montreal Cognitive Assessment [MoCA]) scores were collected from 60 Parkinson's disease and 58 control subjects. Parkinson's disease patients were subgrouped into those with mild cognitive impairment (MoCA < 26), n = 31, and those without mild cognitive impairment (MoCA ≥ 26), n = 29. The coupling strength between the resting-state global blood-oxygen-level-dependent signal and associated CSF flow was quantified, compared among groups, and associated with clinical and structural measurements. RESULTS: Global blood-oxygen-level-dependent signal-CSF coupling decreased significantly (P < 0.006) in Parkinson's disease patients showing mild cognitive impairment, compared with those without mild cognitive impairment and controls. Reduced global blood-oxygen-level-dependent signal-CSF coupling was associated with decreased MoCA scores present in Parkinson's disease patients (P = 0.005) but not in controls (P = 0.65). Weaker global blood-oxygen-level-dependent signal-CSF coupling in Parkinson's disease patients also was associated with a thinner right entorhinal cortex (Spearman's correlation, -0.36; P = 0.012), an early structural change often seen in Alzheimer's disease. CONCLUSIONS: The decoupling between global brain activity and associated CSF flow is related to Parkinson's disease cognitive impairment. © 2021 International Parkinson and Movement Disorder Society.


Assuntos
Disfunção Cognitiva , Doença de Parkinson , Peptídeos beta-Amiloides , Biomarcadores , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Humanos , Doença de Parkinson/complicações , Proteínas tau
5.
Am J Hum Genet ; 98(5): 1001-1010, 2016 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-27108799

RESUMO

Whole-exome sequencing of 13 individuals with developmental delay commonly accompanied by abnormal muscle tone and seizures identified de novo missense mutations enriched within a sub-region of GNB1, a gene encoding the guanine nucleotide-binding protein subunit beta-1, Gß. These 13 individuals were identified among a base of 5,855 individuals recruited for various undiagnosed genetic disorders. The probability of observing 13 or more de novo mutations by chance among 5,855 individuals is very low (p = 7.1 × 10(-21)), implicating GNB1 as a genome-wide-significant disease-associated gene. The majority of these 13 mutations affect known Gß binding sites, which suggests that a likely disease mechanism is through the disruption of the protein interface required for Gα-Gßγ interaction (resulting in a constitutively active Gßγ) or through the disruption of residues relevant for interaction between Gßγ and certain downstream effectors (resulting in reduced interaction with the effectors). Strikingly, 8 of the 13 individuals recruited here for a neurodevelopmental disorder have a germline de novo GNB1 mutation that overlaps a set of five recurrent somatic tumor mutations for which recent functional studies demonstrated a gain-of-function effect due to constitutive activation of G protein downstream signaling cascades for some of the affected residues.


Assuntos
Deficiências do Desenvolvimento/etiologia , Subunidades beta da Proteína de Ligação ao GTP/genética , Mutação em Linhagem Germinativa/genética , Deficiência Intelectual/etiologia , Hipotonia Muscular/etiologia , Convulsões/etiologia , Adolescente , Adulto , Criança , Pré-Escolar , Deficiências do Desenvolvimento/patologia , Exoma/genética , Feminino , Subunidades beta da Proteína de Ligação ao GTP/química , Humanos , Lactente , Deficiência Intelectual/patologia , Masculino , Hipotonia Muscular/patologia , Fenótipo , Conformação Proteica , Convulsões/patologia , Transdução de Sinais , Adulto Jovem
6.
bioRxiv ; 2024 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-38328221

RESUMO

Type 1 diabetes (T1D) is an autoimmune disease in which pancreatic islet ß-cells are attacked by the immune system, resulting in insulin deficiency and hyperglycemia. One of the top non-synonymous single-nucleotide polymorphisms (SNP) associated with T1D is in the interferon-induced helicase C domain-containing protein 1 ( IFIH1 ), which encodes an anti-viral cytosolic RNA sensor. This SNP results in an alanine to threonine substitution at amino acid 946 (IFIH1 A946T ) and confers an increased risk for several autoimmune diseases, including T1D. We hypothesized that the IFIH1 A946T risk variant, ( IFIH1 R ) would promote T1D pathogenesis by stimulating type I interferon (IFN I) signaling leading to immune cell alterations. To test this, we developed Ifih1 R knock-in mice on the non-obese diabetic (NOD) mouse background, a spontaneous T1D model. Our results revealed a modest increase in diabetes incidence and insulitis in Ifih1 R compared to non-risk Ifih1 ( Ifih1 NR ) mice and a significant acceleration of diabetes onset in Ifih1 R females. Ifih1 R mice exhibited a significantly enhanced interferon stimulated gene (ISG) signature compared to Ifih1 NR , indicative of increased IFN I signaling. Ifih1 R mice exhibited an increased frequency of plasma cells as well as tissue-dependent changes in the frequency and activation of CD8 + T cells. Our results indicate that IFIH1 R may contribute to T1D pathogenesis by altering the frequency and activation of immune cells. These findings advance our knowledge on the connection between the rs1990760 variant and T1D. Further, these data are the first to demonstrate effects of Ifih1 R in NOD mice, which will be important to consider for the development of therapeutics for T1D.

7.
Front Immunol ; 15: 1349601, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38487540

RESUMO

Type 1 diabetes (T1D) is an autoimmune disease in which pancreatic islet ß-cells are attacked by the immune system, resulting in insulin deficiency and hyperglycemia. One of the top non-synonymous single-nucleotide polymorphisms (SNP) associated with T1D is in the interferon-induced helicase C domain-containing protein 1 (IFIH1), which encodes an anti-viral cytosolic RNA sensor. This SNP results in an alanine to threonine substitution at amino acid 946 (IFIH1A946T) and confers an increased risk for several autoimmune diseases, including T1D. We hypothesized that the IFIH1A946T risk variant, (IFIH1R) would promote T1D pathogenesis by stimulating type I interferon (IFN I) signaling leading to immune cell alterations. To test this, we developed Ifih1R knock-in mice on the non-obese diabetic (NOD) mouse background, a spontaneous T1D model. Our results revealed a modest increase in diabetes incidence and insulitis in Ifih1R compared to non-risk Ifih1 (Ifih1NR) mice and a significant acceleration of diabetes onset in Ifih1R females. Ifih1R mice exhibited a significantly enhanced interferon stimulated gene (ISG) signature compared to Ifih1NR, indicative of increased IFN I signaling. Ifih1R mice exhibited an increased frequency of plasma cells as well as tissue-dependent changes in the frequency and activation of CD8+ T cells. Our results indicate that IFIH1R may contribute to T1D pathogenesis by altering the frequency and activation of immune cells. These findings advance our knowledge on the connection between the rs1990760 variant and T1D. Further, these data are the first to demonstrate effects of Ifih1R in NOD mice, which will be important to consider for the development of therapeutics for T1D.


Assuntos
Doenças Autoimunes , Diabetes Mellitus Tipo 1 , Feminino , Animais , Camundongos , Helicase IFIH1 Induzida por Interferon/genética , RNA Helicases DEAD-box/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Predisposição Genética para Doença , Camundongos Endogâmicos NOD , Doenças Autoimunes/genética , Interferons/genética
8.
Hum Vaccin Immunother ; 19(3): 2282803, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-38100557

RESUMO

A significant surge in research endeavors leverages the vast potential of high-throughput omic technology platforms for broad profiling of biological responses to vaccines and cutting-edge immunotherapies and stem-cell therapies under development. These profiles capture different aspects of core regulatory and functional processes at different scales of resolution from molecular and cellular to organismal. Systems approaches capture the complex and intricate interplay between these layers and scales. Here, we summarize experimental data modalities, for characterizing the genome, epigenome, transcriptome, proteome, metabolome, and antibody-ome, that enable us to generate large-scale immune profiles. We also discuss machine learning and network approaches that are commonly used to analyze and integrate these modalities, to gain insights into correlates and mechanisms of natural and vaccine-mediated immunity as well as therapy-induced immunomodulation.


Assuntos
Multiômica , Vacinas , Transcriptoma , Aprendizado de Máquina
9.
J Biomol Tech ; 32(4)2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-35837266

RESUMO

Implementing an effective software solution is an important step in managing a portfolio of core facilities. Though commercial options are available, developing or adopting a custom platform is a viable path for many institutions. At Northwestern University (NU), the cores program was reorganized beginning in 2008, and we pursued the latter path in order to retain control of the development priorities and to ensure integration with other enterprise systems. This manuscript describes our experience and results after a decade of effort. The platform, named NUcore, began enrollment in 2011, and full enrollment was achieved in 2019. Key features of NUcore include a stable and secure environment, a responsive and intuitive interface for users and core staff, seamless integration with the university financial system, rules and restrictions to ensure compliance, and both core-specific and enterprise reporting. NUcore now supports nearly half of all sponsored award dollars at NU at a cost of only 1 cent per dollar of business transacted. On average, there are over 4000 active users each year. NUcore is managed as an open-source project, available at no cost to any organization. Five academic organizations currently use the NUcore code base. For NU, NUcore has been a substantial success, and continuous development will ensure that it meets the future needs of our university and its cores.


Assuntos
Comércio , Software , Humanos , Universidades
10.
J Exp Med ; 218(5)2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33724365

RESUMO

SAMD9L is an interferon-induced tumor suppressor implicated in a spectrum of multisystem disorders, including risk for myeloid malignancies and immune deficiency. We identified a heterozygous de novo frameshift variant in SAMD9L in an infant with B cell aplasia and clinical autoinflammatory features who died from respiratory failure with chronic rhinovirus infection. Autopsy demonstrated absent bone marrow and peripheral B cells as well as selective loss of Langerhans and Purkinje cells. The frameshift variant led to expression of a truncated protein with interferon treatment. This protein exhibited a gain-of-function phenotype, resulting in interference in global protein synthesis via inhibition of translational elongation. Using a mutational scan, we identified a region within SAMD9L where stop-gain variants trigger a similar translational arrest. SAMD9L variants that globally suppress translation had no effect or increased mRNA transcription. The complex-reported phenotype likely reflects lineage-dominant sensitivities to this translation block. Taken together, our findings indicate that interferon-triggered SAMD9L gain-of-function variants globally suppress translation.


Assuntos
Mutação da Fase de Leitura , Regulação da Expressão Gênica/genética , Mutação em Linhagem Germinativa , Biossíntese de Proteínas/genética , Proteínas Supressoras de Tumor/genética , Células A549 , Linfócitos B/metabolismo , Linfócitos B/patologia , Evolução Fatal , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Células HEK293 , Heterozigoto , Humanos , Recém-Nascido , Interferons/farmacologia , Síndromes Mielodisplásicas/genética , Síndromes Mielodisplásicas/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Sequenciamento Completo do Genoma
11.
Pediatr Rheumatol Online J ; 18(1): 80, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066778

RESUMO

BACKGROUND: Heme oxygenase-1 (HMOX1) catalyzes the metabolism of heme into carbon monoxide, ferrous iron, and biliverdin. Through biliverdin reductase, biliverdin becomes bilirubin. HMOX1-deficiency is a rare autosomal recessive disorder with hallmark features of direct antibody negative hemolytic anemia with normal bilirubin, hyperinflammation and features similar to macrophage activation syndrome. Clinical findings have included asplenia, nephritis, hepatitis, and vasculitis. Pulmonary features and evaluation of the immune response have been limited. CASE PRESENTATION: We present a young boy who presented with chronic respiratory failure due to nonspecific interstitial pneumonia following a chronic history of infection-triggered recurrent hyperinflammatory flares. Episodes included hemolysis without hyperbilirubinemia, immunodeficiency, hepatomegaly with mild transaminitis, asplenia, leukocytosis, thrombocytosis, joint pain and features of macrophage activation with negative autoimmune serologies. Lung biopsy revealed cholesterol granulomas. He was found post-mortem by whole exome sequencing to have a compound heterozygous paternal frame shift a paternal frame shift HMOX1 c.264_269delCTGG (p.L89Sfs*24) and maternal splice donor HMOX1 (c.636 + 2 T > A) consistent with HMOX1 deficiency. Western blot analysis confirmed lack of HMOX1 protein upon oxidant stimulation of the patient cells. CONCLUSIONS: Here, we describe a phenotype expansion for HMOX1-deficiency to include not only asplenia and hepatomegaly, but also interstitial lung disease with cholesterol granulomas and inflammatory flares with hemophagocytosis present in the bone marrow.


Assuntos
Anemia Hemolítica Congênita , Anemia Hemolítica , Transtornos do Crescimento , Heme Oxigenase-1/deficiência , Hepatomegalia/diagnóstico por imagem , Distúrbios do Metabolismo do Ferro , Insuficiência Respiratória , Baço , Anemia Hemolítica/diagnóstico , Anemia Hemolítica/genética , Anemia Hemolítica Congênita/sangue , Anemia Hemolítica Congênita/diagnóstico , Anemia Hemolítica Congênita/fisiopatologia , Anemia Hemolítica Congênita/terapia , Bilirrubina/sangue , Exame de Medula Óssea/métodos , Criança , Deterioração Clínica , Cuidados Críticos/métodos , Diagnóstico , Evolução Fatal , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/genética , Heme Oxigenase-1/genética , Humanos , Distúrbios do Metabolismo do Ferro/diagnóstico , Distúrbios do Metabolismo do Ferro/genética , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/patologia , Doenças Pulmonares Intersticiais/fisiopatologia , Ativação de Macrófagos , Masculino , Nefrite/diagnóstico , Nefrite/etiologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etiologia , Baço/diagnóstico por imagem , Baço/patologia
12.
Res Soc Work Pract ; 18(4): 285-291, 2008 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-24089591

RESUMO

As evidence-based practice is increasingly accepted in social work, the challenges associated with its actual implementation become more apparent and pressing. This article identifies implementation as a critical issue for research; implementation itself must be better understood if evidence-based practices are to be used and resultant improvements to practice are to be realized. Social work needs to engage more fully in (a) service system research and (b) implementation research, each of which complements and has potential to extend the benefits of efficacy and effectiveness research. Service system research can enhance the fit of empirically supported treatments to the needs of real-world practice and thus facilitate their implementation. Implementation studies examine the acceptability of evidence-based interventions, the feasibility and likelihood of their sustained use, and the decision-support procedures that can help practitioners apply probabilistically based, empirically supported treatments to the individual case in real-world practice.

13.
J Biomol Tech ; 29(3): 79-92, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30140172

RESUMO

Core facilities are an integral component of modern research institutions. Here, we describe our efforts over the past decade to build a sustainable portfolio of core facilities at Northwestern University. Through careful strategic planning, coordination, investment, and oversight, we have developed a model for managing core facilities that addresses researchers' needs within 3 schools across 2 campuses. Our management model is a partnership between core directors and central administrators that maintains operational control of each facility at the local level to ensure that the needs of researchers are being addressed. Central administrative oversight ensures that facilities are compliant with federal regulations, are financially sound, and align with institutional priorities. This hybrid management model is comprised of 4 pillars that are essential and necessary to ensure the long-term viability and success of facilities: core personnel, core space, institutional investment, and institutional evaluation. With these pillars in place, our facilities are well positioned to fulfill their key value propositions, to demonstrate a robust return on the university's investment, and to ensure that facilities remain vibrant, sustainable components of the research ecosystem for the foreseeable future.


Assuntos
Academias e Institutos/organização & administração , Pesquisadores , Universidades/organização & administração , Academias e Institutos/economia , Humanos , Illinois , Investimentos em Saúde , Universidades/economia
15.
Can J Ophthalmol ; 51(6): 445-451, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27938956

RESUMO

OBJECTIVE: This article investigates the prevalence and attributes of patients with open-angle glaucoma who exhibit improvement of visual field loss in a clinical setting. DESIGN: We conducted a retrospective chart review of patients in a clinical glaucoma practice. PARTICIPANTS: We identified 719 glaucoma patients with at least 5 SITA strategy visual field tests and a minimum continuous follow-up period of 5 years. METHODS: The change in the slope of the visual field index (VFI) over time was illustrated using histogram analysis for the study eye with the worst VFI at baseline. Multiple variables were analyzed to determine their impact on rates of visual field progression, including sex, age, disease staging, intraocular pressure (IOP), and incisional surgeries. Eyes with severe nonophthalmic and ophthalmic comorbidities were excluded. RESULTS: Considering 582 eligible eyes, 232 (39.9%) showed significantly positive slopes of the VFI as a function of time, 76 (13.1%) showed nonsignificant slopes, and 276 (47.4%) showed significantly negative slopes. In all, 10 eyes (1.7%) demonstrated VFI slope improvement of ≥2% per year, whereas 21 (3.6%) demonstrated VFI slope reduction ≥2% per year. More advanced disease stage was significantly associated with a negative VFI slope (p < 0.0001). Trabeculectomy and poor compliance were not associated with a negative VFI slope, whereas cataract surgery correlated with higher odds of a negative VFI slope (p = 0.048). CONCLUSIONS: In a clinical setting, a significant VFI improvement over time was observed over an interval of greater than 5 years.


Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Glaucoma de Ângulo Aberto/cirurgia , Trabeculectomia , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tonometria Ocular , Acuidade Visual , Testes de Campo Visual
16.
Adm Policy Ment Health ; 34(5): 479-88, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17636378

RESUMO

Despite a growing supply of evidence-based mental health treatments, we have little evidence about how to implement them in real-world care. This qualitative pilot study captured the perspectives of agency directors on the challenge of implementing evidence-based practices in community mental health agencies. Directors identified challenges as limited access to research, provider resistance, and training costs. Director leadership, support to providers, and partnerships with universities were leverage points to implement evidenced-based treatments. Directors' mental models of EBP invoked such concepts as agency reputation, financial solvency, and market niche. Findings have potential to shape implementation interventions.


Assuntos
Serviços Comunitários de Saúde Mental , Difusão de Inovações , Medicina Baseada em Evidências , Administradores de Instituições de Saúde/psicologia , Humanos , Entrevistas como Assunto , Transtornos Mentais/terapia , Estados Unidos
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